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Individual
THEODORE K KRUTKY
Active
Individual
THEODORE K KRUTKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35039773
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000129127
ANTHEM
OH
05
—
0340867
—
OH
01
—
729848
BUCKEYE COMMUNITY HEALTH
OH
01
—
791111263
RAILROAD MEDICARE
OH
01
—
Q013420
HOMETOWN HEALTH PLAN
OH
Enumeration date
02/21/2006
Last updated
07/09/2009
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